A summary of research projects and publications dealing with mosquitoes, wetlands and urban ecology (as well as other Medical Entomology activities) by Dr Cameron Webb (University of Sydney & Pathology West)

Tag Archives: health warnings

Health authorities in Victoria have been warning of mosquito-borne Ross River virus for much of the summer. The state is experiencing one of its worst outbreaks of the disease but cases have mostly been across inland regions. Now it’s hit Melbourne. How has this happened?

Ross River virus is the most commonly reported mosquito-borne disease in Australia. There are usually about 5,000 cases across Australia. However, in 2015 there was a major spike in activity with around 9,000 cases reported. It is a common misconception that the disease is only found in northern regions of Australia. I’m often told “I heard the disease is moving south from QLD?” That’s not the case.

The virus is just as much a natural part of the Australian environment as the mosquitoes and the wildlife that maintain transmission cycles.

While there are generally more cases in northern Australia, nowhere is safe. Some of the largest outbreaks have occurred in southern regions of Western Australia, South Australia, Victoria and even Tasmania.

The virus is widespread but is generally associated with rural regions. A driving factor in determining the activity of Ross River virus is that more than just mosquitoes are involved in outbreaks. The virus is maintained in the environment in native wildlife, especially kangaroos and wallabies. Even when and where there are high numbers of mosquitoes, without wildlife, outbreak risk is low. This is the reason why any clusters of locally infected cases in metropolitan regions are typical in areas where there are wetlands, wildlife and mosquitoes occurring together. We’ve seen this on the urban fringe of Sydney and Perth in recent years.

The announcement of locally acquired cases in the suburbs of Frankston and Casey, in Melbourne’s south-east, has taken many by surprise. Should it have?

Victoria is no stranger to mosquitoes and outbreaks of mosquito-borne disease. There are mosquito surveillance and mosquito control programs in place in many regions and historically there have been major outbreaks of mosquito-borne disease. From freshwater flood plains of the inland to the tidally flooded estuarine wetlands of the coast, Victoria has diverse and often abundant mosquitoes. But cases in the metropolitan region are rare.

Victorian mosquitoes are not all bad but over a dozen different mosquito species can spread Ross River virus.

The region where these cases have been identified are in proximity to bushland and wetland areas. There is no doubt plenty of mosquitoes and suitable wildlife too. While this is the first time local transmission has been documented, that doesn’t mean the virus hasn’t circulated in the past, or even that cases may have occurred.

For individuals infected but only suffering mild symptoms, the illness can be easily discounted as nothing more than a mild case of the flu. Without appropriate blood tests, these cases never appear in official statistics. For this reason, many mosquito researchers believe that the number of notified cases across the country is just the tip of the iceberg with many milder infections going diagnosed.

But why in Melbourne now?

It is difficult to know for sure. The two most likely explanations are that either environmental conditions were ideal for mosquitoes and suitable populations of wildlife were present so that the virus was much more active in the local environment than previously. The second explanation is that the virus may have been introduced to the region by a traveller or movement of wildlife. In much the same way Zika virus made its way from SE Asia to South America in the last few years, mosquito-borne viruses move about in people and animals, much less so than mosquitoes themselves (but that isn’t impossible either).

Victoria (as well as inland NSW) is experiencing one of its largest outbreaks of Ross River virus on record following significant flooding of inland regions. With so much activity of the virus in the region, perhaps an infected bird or person travelling to the metropolitan region brought the virus with them. When bitten by local mosquitoes, the virus started circulated among local mosquitoes and wildlife.

Most people infected by Ross River virus are bitten by a mosquito that has previously fed on a kangaroo or wallaby.

Once it’s made its way to metropolitan regions, the virus can be spread from person to person by mosquitoes. Common backyard mosquitoes, especially Aedes notoscriptus, can transmit the virus but as these mosquitoes are not particularly abundant, don’t fly vary far and will just as likely bite animals as humans, they’re unlikely to drive major urban outbreaks of the disease. This mosquito doesn’t pack the same virus-spreading-punch as mosquitoes such as Aedes aegypti that spreads dengue, chikungunya and Zika viruses. Aedes aegypti isn’t in Victoria.

We’re unlikely to see significant spread of Ross River virus across Melbourne but that doesn’t mean Victorians should be complacent. As there is no cure for Ross River virus disease, the best approach is to avoid being infected in the first place. Preventing mosquito bites is the best approach. For my tips and tricks on avoiding mosquito bites see this recent paper in Public Health Research and Practice as well as my article for The Conversation.

This is a special guest post from Dr Abbey Potter, Senior Scientific Officer, Environmental Health Hazards, WA Health. I’m currently mentoring Abbey as part of The Public Health Advocacy Institute of WA (PHAIWA)Mentoring Program. Its been a great experience as we navigate through some of the strategies to raise awareness of mosquito-borne disease and advocate for better approaches to addressing the public health risks associated with mosquitoes.

Living in WA, we’re all too familiar with the pesky mosquito. We know they bite but what we often don’t consider is that they can transmit serious and sometimes deadly diseases. In fact, a recent survey of locals indicated that knowledge of mosquito-borne disease is pretty limited, particularly among younger adults aged 18-34 years and those living in the Perth Metro. It’s pretty important we’re aware of the risks posed by these pint-sized blood suckers and how you can avoid them… and here’s why!

Forget the bush, most people bitten in their own backyard. West Aussies are all very prone to getting eaten alive while socialising outdoors but if you’re up in the north of the State, you’ve also got a much higher likelihood of being bitten while boating, camping or fishing or working outside, compared to the rest of the state.

And don’t think you’re off the hook when you head off on holidays. A further 500 WA residents return from overseas travel with an exotic mosquito-borne disease every year. Heading to Bali? Beware of dengue, especially young adult males who return home with the illness more than others. There is limited mosquito management in many overseas countries where disease-transmitting mozzies can bite aggressively both indoors and throughout the day. This catches West Aussies off guard, as we are accustomed to mozzies biting outdoors, around dusk and dawn. When you’re in holiday mode it’s likely that you’ll be relaxing, having a couple of drinks and not thinking about applying repellent. Oddly enough, mosquitoes may actually be more attracted to people whose body temperature is higher. This happens naturally when you consume alcohol, so best pull out the repellent before you crack your first beer.

Despite our attractiveness to mosquitoes, we aren’t really aware of the most effective ways to avoid bites or how we can do our bit to reduce breeding in our own backyards. If you live by the mantra Cover Up. Repel. Clean Up you’ll have no problems!

Western Australia has some amazingly beautiful wetlands but these saltmarshes around Mandurah can produce large populations of nuisance-biting mosquitoes!

Cover Up

If you know you are going to be outdoors when mosquitoes are active, wear loose, long-fitting clothing that is light in colour. Believe it or not, mosquitoes can bite through tight pants as tough as jeans – I’ve witnessed it!

Try to keep children indoors when mosquitoes are most active. If exposure can’t be avoided, dress them appropriately and cover their feet with socks and shoes. Pram netting can also be really useful.

Admittedly, it’s not always practical to wear long sleeves during our warm summer nights, so there are going to be times when you need to use repellent. Choose a product that actually works and apply it appropriately so it does the job. Despite our best intentions, this is where we often go wrong. There are a few basic things to cover here, so stick with it!

Ingredient: Science tells us that the best active ingredient for repelling mosquitoes is diethyltoluamide (DEET for short) or picaridin. You need to look for either one of these names on the repellent label under the ‘active constituents’ section.

Unfortunately, natural repellents and anything wearable (e.g. bands, bracelets or patches) have very limited efficacy. Experts don’t recommend you use them and I consider this very wise advice. It only takes a single mosquito bite to become infected and chances are you will receive at least one if you rely solely on a product of this nature. It just isn’t worth the risk.

Percentage: The next thing to consider is the percentage of the active ingredient. This can range anywhere from 7% to 80% which can make choosing a repellent confusing. Just remember, the higher the percentage, the LONGER the product will remain active for. It doesn’t mean it will repel mosquitoes better.

A repellent containing 16-20% DEET will provide around 4-6 hours of protection, and is a good place to start. Repellents labelled ‘tropical strength’ usually contain greater than 20% DEET – they are useful when you spend longer periods exposed to mosquitoes or if you are heading to a region where dengue, malaria or Zika is problematic. Kids repellents usually contain picaridin or <10% DEET.

Sometimes it can be tricky to work out the percentage of the active ingredient. You can see the Bushmans example below states this clearly, but the other bottles list the ingredient in grams per litre (g/L). No need for complex maths – just divide by 10 and you have the magic number! For example, the RID label below reports the product contains 160g/L of DEET. This would convert to 16% DEET – easy!

You can see a few examples here of effective repellents:

How to Apply: No doubt we would all prefer if repellents didn’t feel quite so gross on our skin or didn’t smell so bad. Even I have to admit that before I moved into this field, I was guilty of putting just a dab here and a dab there. Unfortunately, this is flawed logic that will only result in you being bitten!

Repellents must be applied correctly to be effective. That means reading the label and applying it evenly to all areas of exposed skin. Remember to reapply the product if you are exposed to mosquitoes for longer than the repellent protects you for. You’ll also have to reapply the repellent after sweaty activity or swimming.

For more information on repellent use in adults and children, click here.

Clean Up

Mosquitoes need water to breed, but only a very small amount. Water commonly collects in a range of things you may find in your backyard including pot plant drip trays, toys, old tyres, trailers and clogged up gutters. Mosquitoes also love breeding in pet water bowls, bird baths and pools if the water is not changed weekly or they are not well maintained. Rain water tanks can also be problematic so place some insect proof meshing over any outlets. When you’re holidaying, cover up or remove anything that may collect water.

**

If you need more official info from WA Health about mosquito-borne disease or simple ways to prevent being bitten click here. And if you want to read more about how much West Aussies know (or don’t know) about mossies, check out Abbey’s excellent paper here! Joint the conversation too on Twitter by following Abbey and Cameron.

Water, water everywhere…and mosquitoes soon to follow. It makes sense that with more water you’ll get more mosquitoes and with more mosquitoes you’ll get more mosquito-borne disease. Right? Well, not always.

The flooding has come at a time when the weather in warming up and there are already reports of mosquito numbers increasing. The biggest concern is that once the flood water recede, how long will pools of water remain, have mosquitoes got a “jump start”on the season?

There is no doubt that mosquito populations can increase rapidly following flood. There is even a group of mosquitoes commonly called “floodwater mosquitoes“. The desiccation resistant eggs of these mosquitoes are laying dormant in the cracks and crevices of flood plains, just waiting for the water to arrive. When it floods, the eggs hatch and in about a week or so, swarms of mosquitoes emerge.

For the most part, it isn’t immediately following the flooding, but in the weeks and even months following that can provide the most ideal conditions for mosquitoes. If temperatures aren’t high enough to drive rapid evaporation of ponding (or if additional rainfall keeps them topped up), mosquitoes can start building impressing population abundances. With more mosquitoes, the risk of mosquito-borne disease outbreak can increase.

Rainfall records provided by the Bureau of Meteorology indicate that over the three months to September 2016, some regions of NT, QLD, NSW and Victoria received some of their highest rainfall on record for the period. (Bureau of Meterology)

A look back to floods and mosquito surveillance

In 2011-2012, QLD, NSW and Victoria saw incredible flooding. For those of us working in the field of mosquito-borne disease, we’re well aware of what that flooding can cause. Our attention was sparked when stories starting coming out from locals about this being the biggest flooding since the 1970s. Why was this important? Following flooding in the 1970s, we saw one of the biggest outbreaks of the potentially fatal Murray Valley encephalitis virus Australia has seen. This outbreak, and the response to the actual and potential health impacts, was essentially the genesis of many mosquito-borne disease surveillance programs across the country.

There is little doubt you need mosquitoes about for pathogen transmission. However, for many mosquito-borne diseases, the pathogens that cause the illness in people are naturally found in wildlife. Person to person transmission may occur but for pathogens such as West Nile virus, Ross River virus or Murray Valley encephalitis virus, the mosquitoes that inject their virus-filled saliva into people have bitten birds or mammals previously.

The role of wildlife is important to consider as the flooding may influence mosquito populations but they can also influence wildlife. While kangaroos and wallabies may be adversely impacted by floods, flood waters can provide a major boost for waterbirds.

In some instances, as is the case for Murray Valley encephalitis virus, floods provide ideal conditions for both mosquitoes and birds!

Do floods really cause outbreaks of mosquito-borne disease?

There are few studies that have demonstrated that outbreaks of mosquito-borne disease always occur following floods.

In Australia, a recent review looked at the influence of flooding on cases of Ross River virus disease. They found that the evidence to support a positive association between flooding and RRV outbreaks is largely circumstantial. The trouble in predicting outbreaks of Ross River virus disease is that there can be complex biological, environmental and climatic drivers at work and, irrespective of local flooding, there may be other region-specific issues that either increase or decrease the potential for an outbreak.

What should we expect in Australia as summer approaches?

There is no doubt mosquito repellent will come in handy over the coming months. There are already reports of increased mosquito populations in some parts of the country. While nuisance-biting impacts will be a worry, if mosquito populations further increase following flooding, authorities need to remain mindful of a range of other health risks too.

The good news is that unless higher than normal mosquito populations persist into the warmer months, we may not see major outbreaks of disease. It typically isn’t until November-December that we start to see pathogens circulate more widely among wildlife and mosquitoes. Hopefully, if some hot weather arrives, the flood waters will quickly evaporate and abundant mosquitoes populations won’t continue.